P - 79243REQUEST FOR ELECTRICAL INSPECTION
���� O ��� Q� Mi�nesota Board of Electricity
V 1821 University Avenue Suite 5-128, Saint Paul, Minnesota 55104
(651)642-08001TY/MRS 1-800-627-3529 www.electricity.state.mn.us
NEW O REMODEL ❑ ADDITION ❑ REPAIR Describe -usin the back of the white copy if necessary - the work covered by this request:
XCEL EPIERGY SAVE�''S SVVITCH
GENERAL FEES Outdoor Li htin Standard $1
SERVICES I POWER SUPPLIES Traffic Si nal Standard $5
0 to 400 Amcere (a? $25 SuDPlemental Fee @ $2Q _ _ _ _
0 to 200 Am re $5
Above 200 Am ere $10
AfARM, COMMUNICATION, REMOTE CONTROL, SIGNALING
CIRCISITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aooaratus Cal $.50
Center Pivot Ircioffiion Boom
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177Q6383
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes ihe Service andior Power Supply up to 500 Amperes, All
CircuiGS and Two Inspection Trips Each Dwelling Unit @$60
(minimum total fee is $20) I 20.50
- ,H15 ME� FOR �NSPE�,pi �5E CN�Y
I hereby ce�tify Nal l inspected the electrical insta�labon described heiein on the dates sfated:
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Request Date: Rough-in Inspection Required? ❑ Yes ❑�No Inspedion Other Than Rough-I�: �keady Naer U YYYI Call I
Q7��� You must call the inspeclor when ready! Date Ready:
I certity ihat I am the �ICENSED CONTRACTOR ❑COW�ANY ❑ OWNER and hereby request inspection of the electrical work at:
INBTRUCTONB ON BACK OF YELLOW COPY BOARD OF ELECTRICT' CAPY E&00007A-14 8.1. 2002